The concept of microsurgery has shown incredible growth in recent years. It allows the clinician to perform very precise and atraumatic surgical procedures with smaller instruments and finer suture materials than was formerly possible. But are there additional clinically measurable benefits? Does the use of microsurgical principles and procedures provide relevant advantages over conventional concepts for plastic esthetic periodontal surgery? What of natural appearance, harmonious transitions between tissue structures and the absence of scarring in the esthetic zone? This lecture will address these essential parameters of successful treatment outcomes, and give an overview of innovation and evidence in this field.